Pulmonary Hypertension in End-Stage Renal Disease Patients with Maintenance Hemodialysis

Korean Journal of Nephrology 2011;30(1):48-52.

Chang Su Chung, Young-Ki Lee, Jong Soo Choi, Seung Min Lee, Young Rim Song, Soo Jin Kim, Tae Jin Park, Jieun Oh, Jang Won Seo, Jong-Woo Yoon, Ja-Ryong Koo, Hyung Jik Kim, Jung-Woo Noh and Seonghoon Choi

Department of Internal Medicine, Kidney Research Institute, College of Medicine, Hallym University, Seoul, Korea

원저 : 유지 혈액투석을 받는 말기신질환 환자의 폐고혈압

정창수, 이영기, 최종수, 이승민, 송영림, 김수진, 박태진, 오지은, 서장원, 윤종우, 구자룡, 김형직, 노정우, 최성훈

한림대학교 의과대학 내과학교실 및 한림대학교 신장연구소

Abstract

Purpose: Pulmonary hypertension can occur from diverse etiologies. It was reported that pulmonary hypertension also complicated dialysis patents, but the exact mechanisms were not determined. The aim of this study was to evaluate the prevalence and risk factors of pulmonary hypertension in maintenance hemodialysis patients. In addition, we studied the relationship between pulmonary hypertension and arteriovenous access. Methods: Fifty-nine chronic hemodialysis patients underwent clinical evaluation. Pulmonary artery pressure (PAP) was estimated by Doppler echocardiography. Pulmonary hypertension was defined as PAP ≥35 mmHg. Results: Mean PAP value of subjects was 39.3±13.2 mmHg. Pulmonary hypertension was found in 31 (53%) of patients receiving hemodialysis (49.0±10.6 mmHg; range 37 to 84 mmHg). Clinical and biochemical parameters did not differ significantly between patients with pulmonary hypertension and without pulmonary hypertension. In 19 patients, PAP was elevated from 27.8±10.2 mmHg to 41.8±11.9 mmHg (p<0.001) after onset of hemodialysis via arteriovenous fistula. And pulmonary hypertension developed in 12 of 15 patients with normal PAP after onset of hemodialysis treatment. Conclusion: The prevalence of pulmonary hypertension was high, and hemodialysis via arteriovenous access may be involved in the development of pulmonary hypertension.

Key Words: Hypertension, Pulmonary, Hemodialysis, Arteriovenous fistula